Archive for November 7th, 2007
The very thought of a needle biopsy of the prostate kind of makes me cringe, but if there’s a chance a person has cancer, you kind of want to know for sure. The thing that has always struck me about the needle biopsy method is that the size of the samples are small. They are also spread out because generally there isn’t a real good idea where the cancer is located.
Very often, with a mildly elevated psa, the amount and size of the cancer is miniscule. That’s really good news in that finding cancer when it is in very early stages greatly increases the chances of succesfully treating the cancer. The problem is that, being so small, it is not uncommon for a needle biopsy to miss the cancer. The doctors are pretty sure something is going on, but they aren’t likely to talk the patient into a second round of needle sticks because they couldn’t find anything the first time.
Another problem with the needle biopsy is a situation called needle tracking. This occurs when the doctor is fortunate enough to hit the cancer, thus obtaining a sample, but then drags a cancer contaminated needle back through the wall of the prostate effectively depositing what was a contained cancer outside the prostate.
There is a new diagnostic tool called an MRI-Spectroscopy (MRI-S). the non invasive procedure has shown in tests to be about 75% effective in locating prostate cancer, compared to about 30% for the random needle biopsy method. Once the cancer is located and road mapped, the needle biopsy no longer becomes random, but rather a specifically targeted removal of cancerous cells.
That still leaves the problem of “needle tracking”, but the less times a guy is poked, the less likely that the tracking will occur. Overall this seems like great news.
There was one statement in the article that begs a little more study. “In fact, data from the Detroit Autopsy Study and Memorial Sloan- Kettering shows 30% of 30 year old men have prostate cancer.” If that’s true, probably 110% of guys my age have it. I will check that statement elsewhere and bring it up again.
Bottom line. Nearly 500 men are diagnosed with prostate cancer every day. About 90 die from it every day. The earlier the cancer is detected, the higher the survival rate. From a life insurance standpoint, early detection generally will lead to a lower stage and grade of cancer. Post treatment, a low stage and grade prostate cancer is one of the more insurable cancers out there.
November 7th, 2007
I remember back when I was distance running competitively, reading an article about a marathon runner who had died of a massive heart attack. With no research, I came to the conclusion that a heart attack while running was probably an unstoppable death.
If you think about it, most people that have heart attacks don’t have the event while their heart is working at maximum capacity. So if their heart is working at a more normal pace it seems that the amount of damage done would be less severe. Even with the quick recovery that a well conditioned athlete has, if your heart gives out at 140 beats a minute and can’t slow down, there’s just no way to survive.
I was reading about the marathon runner who died this past weekend, Ryan Shay. Apparently he was diagnosed at age 14 with an enlarged heart. While they haven’t officially linked that to the cause of death, studies have shown that an enlarged heart is the leading cause of death in athletes.
Unfortunately the condition that kills athletes, hypertrophic cardiomyopathy, is hard to distinguish from a condition called athlete’s heart. With athlete’s heart, the heart enlargement is due to the amount of exercise. The thing that differentiates it from cardiomyopathy is that with athlete’s heart, the entire heart has a thickening of the walls, a uniform strengthening. With cardiomyopathy, it is generally just one area of the heart that has thickened walls, creating an imbalance in the way blood is pumped.
Generally an enlarged heart is a treatable health issue. From a life insurance standpoint, with no other risk factors, standard and possibly better rates are possible.
Bottom line. Perhaps there should be closer scrutiny of the type of athletes that push their bodies beyond certain limits. Certainly, as a parent, I can see some logic to having a young athlete get a cardiac workup before letting them take things to a higher level, especially in sports where you have long periods of cardiovascular stress. My condolences go out to Ryan’s family. He sounds like he was an exceptional young man in many ways.
November 7th, 2007
One of the hard facts is that people with type 2 diabetes are at a higher risk of heart disease and heart attacks than the average person. There has been growing concern among physicians that some of the medications used to control type 2 diabetes might also contribute to a higher mortality in those that do suffer heart attacks.
The May Clinic studied about 2700 people in Minnesota, their own backyard, who had suffered heart attacks. 18% of those studied were also diabetic. Of those that had diabetes, they were broken down into the different types of treatment to determine if the treatment in question, know collectively as SU2, had any more impact than other treatment such as insulin.
The study concluded that “These data do not support the concern among some physicians of an adverse impact of SU2 on survival after a heart attack”. Encouraging news for physicians and the patients who have found these drugs helpful in controlling their diabetes. Certainly it would be better to not have the diabetes, but there is some comfort in knowing that, at least, your treatment shouldn’t hasten your death.
Bottom line. In life insurance underwriting of type 2 diabetes, it’s all about control, normally gaged by your hbA1c, and controlling other risk factors. Better than standard rates can be had for someone who really takes the disease by the reins and controls and limits its’ impact on their body.
November 7th, 2007
I have focused so much attention on the impact that obesity can have on a person’s overall health that, honestly, it never occurred to me to look at a far more common occurrence. What kind of impact does a person sustain if they gain10 or 15 pounds?
If I were thrown a question like that on a random quiz, my best guess is that it wouldn’t have any impact other than mild to moderate belt line discomfort. Maybe a little trouble bending over.
The Mayo Clinic takes exception to my answer. In a recent study, they found that moderate weight gain (in their study the average weight gain was 9 pounds), can cause a change in the lining of blood vessels putting the person at higher risk of a heart attack or stroke.
At first I wondered why this would even be studied, but the article clarified that the reason for the study was to find out what happens in the initial stages of a person’s trip to being truly overweight or obese. What they found is that the effects start soon and go steadily downhill if the weight gain isn’t reversed. The good news is that the change in the blood vessels that comes with weight gain is reversible with subsequent weight loss. Once again, making the healthy lifestyle choice pays off.
Bottom line. No one ever said life was going to be easy, but if you make the right decisions and stick to them, they become easier and can have a profound impact on your health, and yes, the life insurance rates you pay. Depending on what your weight is, even the extra 9 pounds they used in the study can put you in a different rate class.
November 7th, 2007
